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Spider question
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by agkistrodude on November 22, 2009
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I met someone today that had lost an arm just below the shoulder. She said it was from a bite from a Brown Recluse, and gave me a brief story of what happened. My question is,... is this highly unusual, or common with these bites? I know 2 other people that have been bitten without nearly this result.Both had a nasty area around the bite that basically rotted away, and received antibiotics I believe, and it healed. Take care, Marty
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RE: Spider question
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by Cro on November 22, 2009
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It is unusual.
There are many cases where the bite from that spider has done tremendous damage, however, the loss of a limb is much more unusual. But it does happen, and examples can be found in the medical literature.
Most likely, if a whole limb were lost, there would have been improper medical treatment, infections, circulation and other medical problems in the patient, etc.
Best Regards
John Z
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RE: Spider question
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by pitbulllady on November 23, 2009
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Thing is, a lot, and I DO mean a LOT, of skin lesions, tissue damage, etc., gets blamed on "spider bites" or "Brown Recluse" bites in particular, with no real proof of such. Doctors routinely diagnose conditions that involve damage to the skin and underlying tissues on spider bites, even when the patient cannot recall being bitten, and do not perform any tests to determine if this is true or not. Even in areas where there are no confirmed L. reclusa populations, they still get blamed. Very often, the culprit is MERSA, or antibiotic-resistant staff, which is surprisingly common and can and does lead to horrific injuries. Any tiny little opening in the skin can allow it to enter and start causing damage, which often does start out with a small pimple or boil and progresses. Years ago, I had a large lesion on my leg which kept getting bigger and would not respond to treatments. My doctor at the time insisted it was a Brown Recluse bite, even though we do not have that species in SC. Eventually, I myself found the real cause-an ingrown HAIR that was coiled up on itself like a rope, nearly three inches long! Once that was extracted, the wound healed. There's been many discussions of the topic of "spider bites" that probably aren't on Arachnoboards.com, by the way, and it seems common for doctors to place the blame on spiders when they cannot make a definitive diagnosis.
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RE: Spider question
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by agkistrodude on November 23, 2009
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I heard her telling someone else that the hospital put her on high doses of steroids, and that shouldn't have been done. That was all I heard on the treatment.
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RE: Spider question
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by agkistrodude on November 23, 2009
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She did say that she saw and killed the spider, but It wasn't brought in for ID as it was smeared into the ground.
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RE: Spider question
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by lanceheads on November 23, 2009
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Check this out:
Anderson, Phillip, C. 1998. Missouri brown recluse spider: a review and update. Missouri Medicine 95: 318-322.
"The entire loxoscelism literature is deficient in failing to produce the evidence that the bite of the Loxosceles reclusa was the cause of the illness reported."
"The spider must be recovered on the site promptly and identified expertly. Clinical impression alone, without other physical evidence, is not sufficiently convincing."
" the early clinical literature about loxoscelism is almost useless."
". several deaths from loxoscelism were reported in medical journals, but none of the reports is convincing. We are not aware of any verifiable deaths caused by the bite of the North American brown recluse spider."
"Almost all brown recluse spider bites heal nicely in two to three months without medical treatment at all. Also the long-term medical outcome is excellent without treatment."
"In my opinion, early debridement without closure or grafting also results in delayed healing, more scarring, and without relief of pain or reduction in risks."
"Systematic loxoscelism is uncommon, especially in adults."
"We estimate that we have seen or reviewed about 1,000 credible recluse spider bites, and we have seen about a dozen cases of impressive, sustained hemolysis."
"It would be fair to estimate that systemic loxoscelism occurs in much less than 1% of cases of focal necrosis of the skin due to loxosotoxin."
"All medically significant recluse spider bites have central necrosis, that is, all of them are seen initially as central sinking blue-gray macules on the skin with a wide halo of mixed erythema and vasoconstriction (red-white-blue). If the central lesion is urticarial or nodular, another kind of injury is involved, not a recluse spider bite. Elderly people with diabetes, chronic liver disease, or alcoholism most often appear with spontaneous necrotizing fasciitis, while healthy children and young adults are the usual patients with loxoscelism."
"..cutaneous loxoscelism is a focal, single necrotic lesion without adenopathy or lymphangitis early, not exudative, not progressive after about 18-24 hours, and associated with only mild fever or toxicity in almost all cases. The patients do not seem very ill."
"Most recluse bites referred to us arrive already on high-dose antibiotics. We have never encountered an infected bite, even in unmedicated patients. Antibiotics are unnecessary, and may lend to a false sense of security or even induce errors in the proper diagnosis of cellulitis. It is best not to use antibiotics except for the credible diagnosis of infection, as against loxoscelism."
"Coagulopathy in adults from an ordinary spider bite is almost never seen."
"With no physician's care at all, most recluse spider bites show an excellent outcome."
"Healing may be slow, but all lesions heal and mostly with a minimum of scarring. Surgery can offer little or nothing more. No medications are required to treat brown recluse spider bites."
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by lepidus on November 24, 2009
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I work in an Emergency Room and see many skin abcesses that are reported by the patients as "spider bites". The majority of the patients when asked if they actually saw a spider, report that they did not and just assumed that it was a spider bite. I'd say probably 99% of the lesions we see are just skin abcesses, probably from staph infections. We don't usually culture the wound unless it is draining. The usual treatment is antibiotics by mouth or a combination of antibiotics by mouth and / or intrvenous / intramuscular injections and debridement when necessary.
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by agkistrodude on November 25, 2009
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So, even if we give her the benefit of the doubt, and go with what she said, she saw the spider that bit her and killed it, it was most likely a secondary infection that did the damage that led to amputation.
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